PMID- 19225832
OWN - NLM
STAT- MEDLINE
DCOM- 20090625
LR  - 20211020
IS  - 0364-2313 (Print)
IS  - 0364-2313 (Linking)
VI  - 33
IP  - 5
DP  - 2009 May
TI  - Lymphatic invasion: an important prognostic factor for stages T1b-T3 gallbladder 
      cancer and an indication for additional radical resection of incidental 
      gallbladder cancer.
PG  - 1035-41
LID - 10.1007/s00268-009-9950-4 [doi]
AB  - BACKGROUND: Laparoscopic cholecystectomy is being performed with increasing 
      frequency worldwide. This has led to more frequent discovery of incidental 
      gallbladder cancer (IGBC) and in turn to the need for an independent prognostic 
      factor for stages T1b-T3 gallbladder cancer so that is can be determined 
      clinically which cases of IGBC are indicated for additional radical resection 
      (ARR). METHODS: A retrospective study was conducted that included 72 patients who 
      underwent macroscopically curative surgical resection (R0, R1) at our center for 
      stages T1b-T3 GBC. Survival analysis was performed, and the usefulness of ARR was 
      analyzed in 15 patients with IGBC. RESULTS: Univariate analysis of 
      disease-specific survival showed stage T3, histologic grade II-IV, lymphatic 
      invasion, vessel invasion, perineural invasion, lymph node metastasis, and a 
      positive resection margin to be factors indicative of poor prognosis. Independent 
      predictors of poor disease-specific survival were stage T3 (hazard ratio, 2.33 
      [95% CI, 1.10-4.95]), lymphatic invasion (5.97 [1.29-27.6]), and a positive 
      resection margin (3.17 [1.51-6.63]). Among the 15 IGBC patients, 4 of 5 patients 
      without lymphatic invasion were cured, 2 of whom underwent cholecystectomy alone; 
      4 of 10 patients with lymphatic invasion did not undergo ARR, and the cancer 
      recurred in all 4 patients; the other 6 patients underwent ARR, and 4 of them 
      were cured by reoperation. CONCLUSIONS: Lymphatic invasion well reflects the 
      malignant phenotype of stages T1b-T3 GBC. We advocate ARR for IGBC patients with 
      lymphatic invasion.
FAU - Shibata, Kohei
AU  - Shibata K
AD  - Department of Surgery I, Oita University Faculty of Medicine, 1-1 Hasama-machi 
      Yufu, Oita 879-5593, Japan. shibatakohei@med.oita-u.ac.jp
FAU - Uchida, Hiroki
AU  - Uchida H
FAU - Iwaki, Kentaro
AU  - Iwaki K
FAU - Kai, Seiichiro
AU  - Kai S
FAU - Ohta, Masayuki
AU  - Ohta M
FAU - Kitano, Seigo
AU  - Kitano S
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Surg
JT  - World journal of surgery
JID - 7704052
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Gallbladder/pathology/surgery
MH  - Gallbladder Neoplasms/diagnosis/*pathology/*surgery
MH  - Humans
MH  - *Incidental Findings
MH  - Lymphatic Metastasis
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local
MH  - Neoplasm Staging
MH  - Prognosis
MH  - Reoperation
MH  - Retrospective Studies
MH  - Survival Analysis
EDAT- 2009/02/20 09:00
MHDA- 2009/06/26 09:00
CRDT- 2009/02/20 09:00
PHST- 2009/02/20 09:00 [entrez]
PHST- 2009/02/20 09:00 [pubmed]
PHST- 2009/06/26 09:00 [medline]
AID - 10.1007/s00268-009-9950-4 [doi]
PST - ppublish
SO  - World J Surg. 2009 May;33(5):1035-41. doi: 10.1007/s00268-009-9950-4.